■比较超声(US)引导的射频消融(RFA)和常规开放甲状腺切除术(OT)治疗良性甲状腺结节(BTN)的有效性。
■回顾性分析2019年3月至2022年3月在南京医科大学附属江宁医院接受手术治疗的103例BTN患者的病历。记录显示53例患者接受US引导RFA(观察组),50例患者接受常规OT(对照组)。围手术期指标(手术持续时间,术中失血,术后住院时间,切口长度,术后12h和24hVAS评分),并发症,甲状腺功能,对两组结节复发情况进行对比分析。
■观察组患者围手术期指标较好,术后12、24h视觉模拟评分(VAS)评分均低于对照组(p<0.05)。观察组并发症发生率明显低于对照组(p<0.05)。术前促甲状腺激素(TSH)水平差异无统计学意义,血清游离甲状腺素(FT4)和血清游离三碘甲状腺原氨酸(FT3)比较(p>0.05)。观察组术后TSH水平较术前升高,且高于对照组,而FT4和FT3水平在术后均下降,且低于对照组(p<0.05)。
■与传统的开放性甲状腺切除术相比,美国指导的RFA创伤较小,更快的恢复,并发症少,BTN患者的治疗对甲状腺功能的影响较小。
UNASSIGNED: To compare the effectiveness of ultrasound (US)-guided radiofrequency ablation (RFA) and conventional open thyroidectomy (OT) in the treatment of benign thyroid nodules (BTN).
UNASSIGNED: Medical records of 103 patients with BTN undergoing surgical treatment at The Affiliated Jiangning Hospital of Nanjing Medical University from March 2019 to March 2022 were retrospectively analyzed. Records show that 53 patients underwent US-guided RFA (observation group) and 50 patients underwent conventional OT (control group). Perioperative indicators (operation duration, intraoperative blood loss, postoperative hospital stay, incision length, and VAS score 12h and 24h after surgery), complications, thyroid function, and nodule recurrence in both groups were compared and analyzed.
UNASSIGNED: Perioperative indicators of patients in the observation group were better, and the visual analogue scale (VAS) scores at 12 and 24 hours after the surgery were lower than those of the control group (p<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (p<0.05). There was no statistically significant difference in the preoperative levels of thyroid-stimulating hormone (TSH), serum free thyroxine (FT4) and serum free triiodothyronine (FT3) between the two groups (p>0.05). The postoperative TSH levels in the observation group increased compared to the preoperative levels and were higher than those in the control group, while FT4 and FT3 levels decreased after surgery and were lower than those in the control group (p<0.05).
UNASSIGNED: Compared to conventional open thyroidectomy, US-guided RFA is associated with less trauma, faster recovery, fewer complications, and less impact on thyroid function in the treatment of patients with BTN.